Percutaneous coronary intervention intravascular ultrasound

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Overview

PCI Approaches:

CAD Revascularization:

Heart Team Approach to Revascularization Decisions
Left Main Coronary Artery Disease
Intervention in left main coronary artery disease
Non-Left Main Coronary Artery Disease
Revascularization to Improve Symptoms
Dual Antiplatelet Therapy Compliance and Stent Thrombosis
Hybrid Coronary Revascularization

Pre-procedural Considerations:

Contrast-Induced Acute Kidney Injury
Anaphylactoid Reactions
Statin Treatment
Bleeding Risk
Role of Onsite Surgical Backup

Procedural Considerations:

Vascular Access
PCI in Specific Clinical Situations:
Asymptomatic Ischemia or CCS Class I or II Angina
CCS Class III Angina
Unstable Angina/Non–ST-Elevation Myocardial Infarction
ST-Elevation Myocardial Infarction:
General and Specific Considerations
Coronary Angiography Strategies in STEMI
Primary PCI of the Infarct Artery
Delayed or Elective PCI in patients with STEMI
Fibrinolytic-Ineligible Patients
Facilitated PCI
Rescue PCI
After Successful Fibrinolysis or for Patients Not Undergoing Primary Reperfusion
Cardiogenic Shock
Prior Coronary Bypass Surgery
Revascularization Before Non-cardiac Surgery
Adjunctive Diagnostic Devices:
Fractional Flow Reserve
Intravascular Ultrasound
Adjunctive Therapeutic Devices:
Coronary Atherectomy
Thrombectomy
Laser Angioplasty
Cutting Balloon Angioplasty
Embolic Protection Devices
Percutaneous Hemodynamic Support Devices
Antiplatelet therapy:
Oral Antiplatelet Therapy
Glycoprotein IIb/IIIa Receptor Antagonists
Intravenous Antiplatelet therapy:
STEMI
UA/NSTEMI
SIHD
Anticoagulant Therapy:
Parenteral Anticoagulants During PCI
Unfractionated Heparin
Enoxaparin
Bivalirudin and Argatroban
Fondaparinux
No-Reflow Pharmacological Therapies
PCI in Specific Anatomic Situations:
Chronic Total Occlusions
Saphenous Vein Grafts
Bifurcation Lesions
Aorto-Ostial Stenoses
Calcified Lesions
PCI in Specific Patient Populations:
Chronic Kidney Disease
Peri-procedural Myocardial Infarction Assessment
Vascular Closure Devices

Post-Procedural Considerations:

Post-procedural Antiplatelet Therapy
Proton Pump Inhibitors and Antiplatelet Therapy
Clopidogrel Genetic Testing
Platelet Function Testing
Restenosis
Exercise Testing
Cardiac Rehabilitation

Quality and Performance Considerations:

Quality and Performance
Certification and Maintenance of Certification
Operator and Institutional Competency and Volume

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

2011 and 2005 ACCF/AHA/SCAI Guidelines for Percutaneous Coronary Intervention (DO NOT EDIT)[1][2]

Intravascular Ultrasound (DO NOT EDIT)[1][2]

Class I
"'1.Before implantation of DES, the interventional cardiologist should discuss with the patient the need for and duration of DAPT and the ability of the patient to comply with and tolerate DAPT. [3] (Level of Evidence: C) "
"'2.DES are useful as an alternative to BMS to reduce the risk of restenosis in cases in which the risk of restenosis is increased and the patient is likely to be able to tolerate and comply with prolonged DAPT ((Level of Evidence: A) " for elective PCI[4][5][6][7][8][9]; (Level of Evidence: C) " for UA/NSTEMI [10]; (Level of Evidence: A) " for STEMI[11][12][13][14][15].
"'3.Balloon angioplasty or BMS should be used in patients with high bleeding risk, inability to comply with 12 months of DAPT, or anticipated invasive or surgical procedures within the next 12 months, during which time DAPT may be interrupted.[16][17][18][19](Level of Evidence: B) "
Class III (Harm)
"1.PCI with coronary stenting should not be performed if the patient is not likely to be able to tolerate and comply with DAPT.[20][21][22][23](Level of Evidence: B) "
"2.DES should not be implanted if the patient is not likely to be able to tolerate and comply with prolonged DAPT or this cannot be determined before stent implantation.[24][25][26][27](Level of Evidence: B) "
"3. IVUS for routine lesion assessment is not recommended when revascularization with PCI or CABG is not being contemplated. (Level of Evidence: C)"
Class IIa
"1. Intravascular ultrasound (IVUS) is reasonable for the assessment of angiographically indeterminant left main CAD.[28][29][30] (Level of Evidence: B)"
"2. IVUS and coronary angiography are reasonable 4 to 6 weeks and 1 year after cardiac transplantation to exclude donor CAD, detect rapidly progressive cardiac allograft vasculopathy, and provide prognostic information.[31][32][33] (Level of Evidence: B)"
"3. IVUS is reasonable to determine the mechanism of stent restenosis. [34] (Level of Evidence: C)"
Class IIb
"1. IVUS may be reasonable for the assessment of non–left main coronary arteries with angiographically intermediate coronary stenoses (50% to 70% diameter stenosis).[28][35][36] (Level of Evidence: B)"
"2. IVUS may be considered for guidance of coronary stent implantation, particularly in cases of left main coronary artery stenting.[29][34][37] (Level of Evidence: B)"
"3. IVUS may be reasonable to determine the mechanism of stent thrombosis.[34] (Level of Evidence: C)"

References

  1. ↑ 1.0 1.1 Levine GN, Bates ER, Blankenship JC, Bailey SR, Bittl JA, Cercek B, Chambers CE, Ellis SG, Guyton RA, Hollenberg SM, Khot UN, Lange RA, Mauri L, Mehran R, Moussa ID, Mukherjee D, Nallamothu BK, Ting HH (2011). "2011 ACCF/AHA/SCAI Guideline for Percutaneous Coronary Intervention: Executive Summary A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines and the Society for Cardiovascular Angiography and Interventions" (PDF). Journal of the American College of Cardiology. 58 (24): 2550–83. doi:10.1016/j.jacc.2011.08.006. PMID 22070837. Retrieved 2011-12-08. Text "PDF" ignored (help); Unknown parameter |month= ignored (help)
  2. ↑ 2.0 2.1 Smith SC, Feldman TE, Hirshfeld JW, Jacobs AK, Kern MJ, King SB; et al. (2006). "ACC/AHA/SCAI 2005 guideline update for percutaneous coronary intervention: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (ACC/AHA/SCAI Writing Committee to Update 2001 Guidelines for Percutaneous Coronary Intervention)". Circulation. 113 (7): e166–286. doi:10.1161/CIRCULATIONAHA.106.173220. PMID 16490830.
  3. ↑ Eisenstein EL, Anstrom KJ, Kong DF, et al. Clopidogrel use and long-term clinical outcomes after drug-eluting stent implantation. JAMA. 2007; 297: 159– 68.
  4. ↑ Moses JW, Leon MB, Popma JJ, et al. Sirolimus-eluting stents versus standard stents in patients with stenosis in a native coronary artery. N Engl J Med. 2003; 349: 1315– 23.
  5. ↑ Stone GW, Ellis SG, Cox DA, et al. One-year clinical results with the slow-release, polymer-based, paclitaxel-eluting TAXUS stent: the TAXUS-IV trial. Circulation. 2004; 109: 1942– 7.
  6. ↑ Mauri L, Silbaugh TS, Garg P, et al. Drug-eluting or bare-metal stents for acute myocardial infarction. N Engl J Med. 2008; 359: 1330– 42.
  7. ↑ Stone GW, Lansky AJ, Pocock SJ, et al. Paclitaxel-eluting stents versus bare-metal stents in acute myocardial infarction. N Engl J Med. 2009; 360: 1946– 59.
  8. ↑ Stone GW, Lansky AJ, Pocock SJ, et al. Paclitaxel-eluting stents versus bare-metal stents in acute myocardial infarction. N Engl J Med. 2009; 360: 1946– 59.
  9. ↑ Mehilli J, Pache J, Abdel-Wahab M, et al. Drug-eluting versus bare-metal stents in saphenous vein graft lesions (ISAR-CABG): a randomised controlled superiority trial. Lancet, published online before print August 28, 2011, doi:10.1016/S0140-6736(11)61255-5.
  10. ↑ Mauri L, Silbaugh TS, Garg P, et al. Drug-eluting or bare-metal stents for acute myocardial infarction. N Engl J Med. 2008; 359: 1330– 42.
  11. ↑ Mauri L, Silbaugh TS, Garg P, et al. Drug-eluting or bare-metal stents for acute myocardial infarction. N Engl J Med. 2008; 359: 1330– 42.
  12. ↑ Stone GW, Lansky AJ, Pocock SJ, et al. Paclitaxel-eluting stents versus bare-metal stents in acute myocardial infarction. N Engl J Med. 2009; 360: 1946– 59.
  13. ↑ Pan XH, Chen YX, Xiang MX, et al. A meta-analysis of randomized trials on clinical outcomes of paclitaxel-eluting stents versus bare-metal stents in ST-segment elevation myocardial infarction patients. J Zhejiang Univ Sci B. 2010; 11: 754– 61.
  14. ↑ Hao PP, Chen YG, Wang XL, et al. Efficacy and safety of drug-eluting stents in patients with acute ST-segment-elevation myocardial infarction: a meta-analysis of randomized controlled trials. Tex Heart Inst J. 2010; 37: 516– 24.
  15. ↑ Suh HS, Song HJ, Choi JE, et al. Drug-eluting stents versus bare-metal stents in acute myocardial infarction: a systematic review and meta-analysis. Int J Technol Assess Health Care. 2011; 27: 11– 22.
  16. ↑ Grines CL, Bonow RO, Casey DE Jr., et al. Prevention of premature discontinuation of dual antiplatelet therapy in patients with coronary artery stents: a science advisory from the American Heart Association, American College of Cardiology, Society for Cardiovascular Angiography and Interventions, American College of Surgeons, and American Dental Association, with representation from the American College of Physicians. J Am Coll Cardiol. 2007; 49: 734– 9.
  17. ↑ Park DW, Park SW, Park KH, et al. Frequency of and risk factors for stent thrombosis after drug-eluting stent implantation during long-term follow-up. Am J Cardiol. 2006; 98: 352– 6.
  18. ↑ Spertus JA, Kettelkamp R, Vance C, et al. Prevalence, predictors, and outcomes of premature discontinuation of thienopyridine therapy after drug-eluting stent placement: results from the PREMIER registry. Circulation. 2006; 113: 2803– 9.
  19. ↑ Nasser M, Kapeliovich M, Markiewicz W. Late thrombosis of sirolimus-eluting stents following noncardiac surgery. Catheter Cardiovasc Interv. 2005; 65: 516– 9.
  20. ↑ Grines CL, Bonow RO, Casey DE Jr., et al. Prevention of premature discontinuation of dual antiplatelet therapy in patients with coronary artery stents: a science advisory from the American Heart Association, American College of Cardiology, Society for Cardiovascular Angiography and Interventions, American College of Surgeons, and American Dental Association, with representation from the American College of Physicians. J Am Coll Cardiol. 2007; 49: 734– 9.
  21. ↑ Leon MB, Baim DS, Popma JJ, et al., Stent Anticoagulation Restenosis Study Investigators. A clinical trial comparing three antithrombotic-drug regimens after coronary-artery stenting. N Engl J Med. 1998; 339: 1665– 71.
  22. ↑ Mauri L, Hsieh WH, Massaro JM, et al. Stent thrombosis in randomized clinical trials of drug-eluting stents. N Engl J Med. 2007; 356: 1020– 9.
  23. ↑ McFadden EP, Stabile E, Regar E, et al. Late thrombosis in drug-eluting coronary stents after discontinuation of antiplatelet therapy. Lancet. 2004; 364: 1519– 21.
  24. ↑ Grines CL, Bonow RO, Casey DE Jr., et al. Prevention of premature discontinuation of dual antiplatelet therapy in patients with coronary artery stents: a science advisory from the American Heart Association, American College of Cardiology, Society for Cardiovascular Angiography and Interventions, American College of Surgeons, and American Dental Association, with representation from the American College of Physicians. J Am Coll Cardiol. 2007; 49: 734– 9.
  25. ↑ Park DW, Park SW, Park KH, et al. Frequency of and risk factors for stent thrombosis after drug-eluting stent implantation during long-term follow-up. Am J Cardiol. 2006; 98: 352– 6.
  26. ↑ Spertus JA, Kettelkamp R, Vance C, et al. Prevalence, predictors, and outcomes of premature discontinuation of thienopyridine therapy after drug-eluting stent placement: results from the PREMIER registry. Circulation. 2006; 113: 2803– 9.
  27. ↑ Nasser M, Kapeliovich M, Markiewicz W. Late thrombosis of sirolimus-eluting stents following noncardiac surgery. Catheter Cardiovasc Interv. 2005; 65: 516– 9.
  28. ↑ 28.0 28.1 Briguori C, Anzuini A, Airoldi F, Gimelli G, Nishida T, Adamian M, Corvaja N, Di Mario C, Colombo A (2001). "Intravascular ultrasound criteria for the assessment of the functional significance of intermediate coronary artery stenoses and comparison with fractional flow reserve". The American Journal of Cardiology. 87 (2): 136–41. PMID 11152827. Retrieved 2011-12-09. Unknown parameter |month= ignored (help)
  29. ↑ 29.0 29.1 Fassa AA, Wagatsuma K, Higano ST, Mathew V, Barsness GW, Lennon RJ, Holmes DR, Lerman A (2005). "Intravascular ultrasound-guided treatment for angiographically indeterminate left main coronary artery disease: a long-term follow-up study". Journal of the American College of Cardiology. 45 (2): 204–11. doi:10.1016/j.jacc.2004.09.066. PMID 15653016. Retrieved 2011-12-09. Unknown parameter |month= ignored (help)
  30. ↑ Kang SJ, Lee JY, Ahn JM, Mintz GS, Kim WJ, Park DW, Yun SC, Lee SW, Kim YH, Lee CW, Park SW, Park SJ (2011). "Validation of intravascular ultrasound-derived parameters with fractional flow reserve for assessment of coronary stenosis severity". Circulation. Cardiovascular Interventions. 4 (1): 65–71. doi:10.1161/CIRCINTERVENTIONS.110.959148. PMID 21266708. Retrieved 2011-12-09. Unknown parameter |month= ignored (help)
  31. ↑ Costanzo MR, Dipchand A, Starling R, Anderson A, Chan M, Desai S, Fedson S, Fisher P, Gonzales-Stawinski G, Martinelli L, McGiffin D, Smith J, Taylor D, Meiser B, Webber S, Baran D, Carboni M, Dengler T, Feldman D, Frigerio M, Kfoury A, Kim D, Kobashigawa J, Shullo M, Stehlik J, Teuteberg J, Uber P, Zuckermann A, Hunt S, Burch M, Bhat G, Canter C, Chinnock R, Crespo-Leiro M, Delgado R, Dobbels F, Grady K, Kao W, Lamour J, Parry G, Patel J, Pini D, Towbin J, Wolfel G, Delgado D, Eisen H, Goldberg L, Hosenpud J, Johnson M, Keogh A, Lewis C, O'Connell J, Rogers J, Ross H, Russell S, Vanhaecke J (2010). "The International Society of Heart and Lung Transplantation Guidelines for the care of heart transplant recipients". The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation. 29 (8): 914–56. doi:10.1016/j.healun.2010.05.034. PMID 20643330. Retrieved 2011-12-10. Unknown parameter |month= ignored (help)
  32. ↑ Kobashigawa JA, Tobis JM, Starling RC, Tuzcu EM, Smith AL, Valantine HA, Yeung AC, Mehra MR, Anzai H, Oeser BT, Abeywickrama KH, Murphy J, Cretin N (2005). "Multicenter intravascular ultrasound validation study among heart transplant recipients: outcomes after five years". Journal of the American College of Cardiology. 45 (9): 1532–7. doi:10.1016/j.jacc.2005.02.035. PMID 15862430. Retrieved 2011-12-10. Unknown parameter |month= ignored (help)
  33. ↑ Kapadia SR, Nissen SE, Ziada KM, Guetta V, Crowe TD, Hobbs RE, Starling RC, Young JB, Tuzcu EM (1998). "Development of transplantation vasculopathy and progression of donor-transmitted atherosclerosis: comparison by serial intravascular ultrasound imaging". Circulation. 98 (24): 2672–8. PMID 9851952. Retrieved 2011-12-10. Unknown parameter |month= ignored (help)
  34. ↑ 34.0 34.1 34.2 Dangas GD, Claessen BE, Caixeta A, Sanidas EA, Mintz GS, Mehran R (2010). "In-stent restenosis in the drug-eluting stent era". Journal of the American College of Cardiology. 56 (23): 1897–907. doi:10.1016/j.jacc.2010.07.028. PMID 21109112. Retrieved 2011-12-10. Unknown parameter |month= ignored (help)
  35. ↑ Takagi A, Tsurumi Y, Ishii Y, Suzuki K, Kawana M, Kasanuki H (1999). "Clinical potential of intravascular ultrasound for physiological assessment of coronary stenosis: relationship between quantitative ultrasound tomography and pressure-derived fractional flow reserve". Circulation. 100 (3): 250–5. PMID 10411848. Retrieved 2011-12-10. Unknown parameter |month= ignored (help)
  36. ↑ Magni V, Chieffo A, Colombo A (2009). "Evaluation of intermediate coronary stenosis with intravascular ultrasound and fractional flow reserve: Its use and abuse". Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions. 73 (4): 441–8. doi:10.1002/ccd.21812. PMID 19133668. Retrieved 2011-12-10. Unknown parameter |month= ignored (help)
  37. ↑ Park SJ, Kim YH, Park DW, Lee SW, Kim WJ, Suh J, Yun SC, Lee CW, Hong MK, Lee JH, Park SW (2009). "Impact of intravascular ultrasound guidance on long-term mortality in stenting for unprotected left main coronary artery stenosis". Circulation. Cardiovascular Interventions. 2 (3): 167–77. doi:10.1161/CIRCINTERVENTIONS.108.799494. PMID 20031713. Retrieved 2011-12-10. Unknown parameter |month= ignored (help)

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